The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking

Rui Shi; Zhi-Gang Yang; Ying-Kun Guo; Wen-Lei Qian; Yue Gao; Xue-Ming Li; Li Jiang; Hua-Yan Xu; Yuan Li

doi:10.1186/s12933-023-01806-7

The right ventricular dysfunction and ventricular interdependence in patients with DM: assessment using cardiac MR feature tracking

Cardiovasc Diabetol. 2023 Apr 21;22(1):93. doi: 10.1186/s12933-023-01806-7.

Authors

Rui Shi¹, Zhi-Gang Yang¹, Ying-Kun Guo², Wen-Lei Qian¹, Yue Gao¹, Xue-Ming Li¹, Li Jiang¹, Hua-Yan Xu², Yuan Li³

Affiliations

¹ Department of Radiology, West China Hospital, Sichuan University, No. 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
² Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, China.
³ Department of Radiology, West China Hospital, Sichuan University, No. 37# Guo Xue Xiang, Chengdu, 610041, Sichuan, China. dr.liyuan@163.com.

Abstract

Background: To investigate the difference of right ventricular (RV) structural and functional alteration in patients with diabetes mellitus (DM) with preserved left ventricular ejection fraction (LVEF), and the ventricular interdependence in these patients, using cardiac MR (CMR) feature tracking.

Methods: From December 2016 to February 2022, 148 clinically diagnosed patients with DM who underwent cardiac MR (CMR) in our hospital were consecutively recruited. Fifty-four healthy individuals were included as normal controls. Biventricular strains, including left/right ventricular global longitudinal strain (LV-/RVGLS), left/right ventricular global circumferential strain (LV-/RVGCS), left/right ventricular global radial strain (LV-/RVGRS) were evaluated, and compared between patients with DM and healthy controls. Multiple linear regression and mediation analyses were used to evaluate DM's direct and indirect effects on RV strains.

Results: No differences were found in age (56.98 ± 10.98 vs. 57.37 ± 8.41, p = 0.985), sex (53.4% vs. 48.1%, p = 0.715), and body surface area (BSA) (1.70 ± 0.21 vs. 1.69 ± 0.17, p = 0.472) between DM and normal controls. Patients with DM had decreased RVGLS (- 21.86 ± 4.14 vs. - 24.49 ± 4.47, p = 0.001), RVGCS (- 13.16 ± 3.86 vs. - 14.92 ± 3.08, p = 0.011), and no decrease was found in RVGRS (22.62 ± 8.11 vs. 23.15 ± 9.05, p = 0.743) in patients with DM compared with normal controls. The difference in RVGLS between normal controls and patients with DM was totally mediated by LVGLS (indirect effecting: 0.655, bootstrapped 95%CI 0.138-0.265). The difference in RVGCS between normal controls and DM was partly mediated by the LVGLS (indirect effecting: 0.336, bootstrapped 95%CI 0.002-0.820) and LVGCS (indirect effecting: 0.368, bootstrapped 95%CI 0.028-0.855).

Conclusions: In the patients with DM and preserved LVEF, the difference in RVGLS between DM and normal controls was totally mediated by LVGLS. Although there were partly mediating effects of LVGLS and LVGCS, the decrease in RVGCS might be directly affected by the DM.

Keywords: CMR feature-tracking; Diabetes mellitus; Right ventricular dysfunction; Ventricular interdependence.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Diabetes Mellitus*
Heart Ventricles / diagnostic imaging
Humans
Stroke Volume
Ventricular Dysfunction, Left* / diagnostic imaging
Ventricular Dysfunction, Left* / etiology
Ventricular Dysfunction, Right* / diagnostic imaging
Ventricular Dysfunction, Right* / etiology
Ventricular Function, Left